CN100528167C - Pharmaceutical compositions comprising estetrol derivatives for use in cancer therapy - Google Patents
Pharmaceutical compositions comprising estetrol derivatives for use in cancer therapy Download PDFInfo
- Publication number
- CN100528167C CN100528167C CNB2003801074356A CN200380107435A CN100528167C CN 100528167 C CN100528167 C CN 100528167C CN B2003801074356 A CNB2003801074356 A CN B2003801074356A CN 200380107435 A CN200380107435 A CN 200380107435A CN 100528167 C CN100528167 C CN 100528167C
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- China
- Prior art keywords
- estrogen
- tumor
- application
- mammal
- administration
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- 239000008194 pharmaceutical composition Substances 0.000 title claims description 5
- AJIPIJNNOJSSQC-NYLIRDPKSA-N estetrol Chemical class OC1=CC=C2[C@H]3CC[C@](C)([C@H]([C@H](O)[C@@H]4O)O)[C@@H]4[C@@H]3CCC2=C1 AJIPIJNNOJSSQC-NYLIRDPKSA-N 0.000 title description 4
- 238000011275 oncology therapy Methods 0.000 title description 2
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- 238000000034 method Methods 0.000 claims abstract description 51
- 238000011282 treatment Methods 0.000 claims abstract description 43
- 230000001076 estrogenic effect Effects 0.000 claims abstract description 35
- 241000124008 Mammalia Species 0.000 claims abstract description 18
- 239000002243 precursor Substances 0.000 claims abstract description 18
- 208000001333 Colorectal Neoplasms Diseases 0.000 claims abstract description 14
- 125000002887 hydroxy group Chemical group [H]O* 0.000 claims abstract description 13
- 239000000203 mixture Substances 0.000 claims abstract description 10
- 125000004435 hydrogen atom Chemical group [H]* 0.000 claims abstract description 9
- 125000004432 carbon atom Chemical group C* 0.000 claims abstract 2
- 201000011510 cancer Diseases 0.000 claims description 24
- 230000005764 inhibitory process Effects 0.000 claims description 21
- 239000003814 drug Substances 0.000 claims description 17
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- 238000007920 subcutaneous administration Methods 0.000 claims description 10
- 229910052799 carbon Inorganic materials 0.000 claims description 9
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- 238000001990 intravenous administration Methods 0.000 claims description 6
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- 125000000217 alkyl group Chemical group 0.000 claims description 3
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- DNXHEGUUPJUMQT-UHFFFAOYSA-N (+)-estrone Natural products OC1=CC=C2C3CCC(C)(C(CC4)=O)C4C3CCC2=C1 DNXHEGUUPJUMQT-UHFFFAOYSA-N 0.000 description 3
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- 230000002103 transcriptional effect Effects 0.000 description 1
- 238000001890 transfection Methods 0.000 description 1
- 230000004614 tumor growth Effects 0.000 description 1
- WMPQMBUXZHMEFZ-YJPJVVPASA-N turosteride Chemical compound CN([C@@H]1CC2)C(=O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H](C(=O)N(C(C)C)C(=O)NC(C)C)[C@@]2(C)CC1 WMPQMBUXZHMEFZ-YJPJVVPASA-N 0.000 description 1
- 229950007816 turosteride Drugs 0.000 description 1
- 229960002647 warfarin sodium Drugs 0.000 description 1
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
- A61K31/565—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- General Health & Medical Sciences (AREA)
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Abstract
The present invention relates to a method of treating or preventing estrogen-suppressed tumours in a mammal, said method comprising the administration of a therapeutically effective amount of an estrogenic component to said mammal, wherein the estrogenic component is selected from the group consisting of: substances represented by the following formula (I) in which formula R>1<, R>2<, R>3<, R>4<, independently are a hydrogen atom, a hydroxyl group or an alkoxy group with 1-5 carbon atoms; precursors capable of liberating a substance according to the aforementioned formula when used in the present method; and mixtures of one or more of the aforementioned substances and/or precursors. The estrogenic component according to the invention is particularly useful in the treatment or prevention of colorectal and prostate cancer and, unlike commonly used estrogens, does not simultaneously enhance the risk of estrogen-stimulated cancers such as breast cancer.
Description
Technical field
The present invention relates to a kind of by to the special estrogenic component of described mammal effective dosage with treatment or prevention mammal in the method for estrogen inhibition type tumor (estrogen-suppressed tumor).This method is particularly useful for treatment or prevention colorectal carcinoma and carcinoma of prostate.
Technical background
Colorectal carcinoma is a kind of malignancy disease.The colorectal carcinoma incidence rate is very high in the west.This class tumor often shifts by lymphatic vessel and blood vessel.Many patients that suffer from colorectal carcinoma finally die from this disease.So far, developed systemic treatment and chemotherapy is used for the treatment of colorectal carcinoma.Yet, can demonstrate enough active anticancers without any Therapeutic Method, prolong colorectal carcinoma metastatic disease patient's existence with any reliability.Therefore, still need to develop a kind of method that can successfully treat or prevent colorectal carcinoma.
Al-Azzawi etc. one piece of article (" Estrogen and colon cancer:current issues ", Climacteric 2002; The sick data of learning of current popular of the M ﹠ M of colon cancer in the postmenopausal women who uses Hormone Replacement Therapy have been summarized 5:3-14).Hormone Replacement Therapy (HRT) comprises the symptom that administration estrogen is caused by estrogenic shortage (estrogen deficiency) with prevention or treatment.Author's conclusion is, uses estrogen can produce comprehensive protection, and the sickness rate of adenoma of colon and cancer descends about 30% simultaneously.It is said, use estrogen can reduce the mortality rate relevant with colon cancer.
US 6,291, and 456 (Signal Pharmaceuticals Inc.) relate to by estrogen receptor coming the chemical compound of regulator gene expression and being used for the treatment of the method that a large amount of estrogen relative diseases comprise colon cancer.The chemical compound of this United States Patent (USP) comprises estrogen antagonist and agonist.Observing those estrogen antagonist chemical compounds in this patent can be used as the estrogen antagonist medicine and therefore can be used for prevention and treatment breast carcinoma and ovarian cancer in as breast and ovary tissue.Those estrogen agonist chemical compounds then recommend to be used for other treatment and prophylactic applications.
Shown in above-mentioned patent disclosure, once there was prompting female administration estrogen after menopause can help to reduce the danger of suffering from colon cancer in the prior art.Yet this observations can not prove automatically that treating or prevent estrogen inhibition type cancer such as colon cancer by administration estrogen is this desirable conclusion.In fact, well-known is by inducing the raising of cell division (propagation) frequency of estrogen receptor mediation in these tissues, estrogen can increase " estrogen stimulating type cancer " (estrogen-stimulated cancer) as female carcinoma of endometrium (Cushing etc., 1998.ObstetGynecol.91,35-39; Tavani etc., 1999.Drugs Aging, 14,347-357) and the female and male breast carcinoma that all has (Tavani etc., 1999.Drugs Aging, 14,347-357; Pike etc., 2000.Steroids, 65,659-664, Heinig etc., 2002, European Journal ofObstetrics; Gynecology, 102, danger 67-73).Owing to itself can increase gene and make a mistake, especially as the risk of the gene mistake of tumor suppressor gene inactivation, cell division is essential in the complex process of human cancer generation.
Because aforementioned estrogen stimulating type cancer is very high at the sickness rate of industrial country, administration estrogen is with very great defective in treating or preventing as colon cancer.Therefore need to be applied to treat estrogen inhibition type tumor and do not increase the estrogen of the danger of suffering from estrogen stimulating type tumor.
In the U.S., the death that carcinoma of prostate causes occupy second of male cancer mortality rate.In the past 60 years, hormone therapy has become the critical treatment method of advanced prostate cancer.A kind of this method is for using diethylstilbestrol (DES) to suppress the androgenic generation of endogenous.Known DES is a kind of material with estrogen activity.Yet significant Cardiovascular Toxicity is hindered the use of DES.In prostate treatment, the strategy that reduces thromboembolic events is as reducing dosage or using not achieving success (Malkwicz etc. of warfarin sodium, " The role of diethylstilbestrol in the treatmentof prostate cancer, " Urology 2001 Aug; 58 (2Suppl 1): 108-13).In addition, the application of DES is considered to improve the danger that suffers from breast cancer.
Therefore, need a kind ofly to can be used for treating or preventing estrogen inhibition type tumor such as colorectum tumor or tumor of prostate and can not bring the estrogen substance that develops the dangerous of estrogen stimulating type cancer or show serious Cardiovascular Toxicity.
Summary of the invention
The present inventor finds that unexpectedly the estrogen substance of following general formula representative can satisfy aforementioned needs:
Its Chinese style R
1, R
2, R
3, R
4Be hydrogen atom, hydroxyl or the alkoxyl that contains 1-5 carbon atom independently.
Known 1,3,5 (10)-estratriene-3,15 α that are represented as of this group estrogen substance, 16 α, 17 β-tetrol are called E4 (estetrol), female steroid tetrol (oestetrol) and 15 Alpha-hydroxy estriol again.E4 is a kind of estrogen that is produced by fetus liver during the human pregnancy.Non-binding E4 horizontal peak is 1.2ng/ml in the full-term pregnancy parent blood plasma, and the level in the fetus blood plasma be in the parent blood plasma 12 times of level (Tulchinsky etc., 1975.J.Clin.Endocrinol.Metab., 40,560-567).
US 5,340,585 and US 5,340,584 put down in writing and treated compositions and the method for optimum gynecological imbalance as premenstrual syndrome, it comprises administering drug combinations GnRH component and estrogenic component.US5,340,585 mention that further using this method reduces the danger that suffers from breast cancer with ovarian cancer.A kind of cancer in back is considered to the estrogen-sensitive cancer usually, i.e. its formation and growth can especially be selected from the cancer that estrogen excited of 17 beta estradiols, ethinylestradiol and precursor thereof and metabolite by the estrogen except that estrogenic component of the present invention.
Beat allly be, estimate that with the technical staff estrogen substance can promote the formation of this class tumor and grow differently, estrogen substance of the present invention does not increase the danger of suffering from estrogen stimulating type tumor.Because it seems that estrogen substance of the present invention do not have the estrogen antagonist properties, this discovery is unexpected really.
It is found that estrogen substance of the present invention has high relatively affinity to ER α receptor, or on the contrary the ER beta receptor is had low relatively affinity.It is relevant with a following observed result to a certain extent that this receptor-specific is considered to, and promptly this material is different with normally used estrogen, can not stimulate the hyperblastosis of estrogen stimulating type.Yet,, domination is caused the mechanism of the ER signal path of this phenomenon up to the present still understand seldom although carrying out a large amount of science effort in this field.
Known most estrogen all combines with two kinds of ER, and these ER are attached to the estrogen response element in Gene regulation district in the presence of tissue specificity coactivator and/or corpresor, or is attached to other transcription factor.In view of the complexity of ER signal and the tissue specific expression of ER α and ER β and cofactor thereof, recognized that now the ER part can tissue-specific mode play an estrogen agonist or an even estrogen antagonist.
Nowadays also known estrogen is regulated cellular pharmacology by gene expression, and this estrogen action is mediated by estrogen receptor.Estrogen receptor to the effect of Gene regulation can combine by ER and estrogen response element direct, ER and other transcription factor such as NF-? the combination of B, C/EBP β and regulate by the non-genomic effect that comprises the ion channel receptor.The progress of several years in past shows, ER can with equally can tissue specificity and ligand specificity's mode coactivator (as SRC-1, CBP and SRA) and the corpresor (as SMRT and N-CoR) of regulating the ER transcriptional activity associate.In addition, evidence show that at present the gene of most of estrogen regulating does not have typical estrogen response element.In this case, ER with to regulating the transcription factor interaction of these gene keys.Knownly regulate its active transcription factor by ER and comprise as AP-1, NF-? B, C/EBP and Sp-1.
In view of the complexity of ER signal with express ER with and various types of tissues of cofactor, it has been generally acknowledged that the ER part can not be divided into simple antagonist or agonist more simply.This viewpoint obtains the support of the discovery of Paech etc. (Science 277,1508-1510,1997), and according to him, 17 beta estradiols activate the AP-1 site in the presence of ER α, but in the presence of ER β this same site of inhibition.On the contrary, ER part raloxifene (Eli Lilly ﹠amp; Co.) and tamoxifen and ICI-182,780 (Zeneca Pharmaceuticals) excite the AP-1 site by ER β, but suppress this site in the presence of ER α.
As mainly being analyzed by RT-PCR or in situ hybridization, known ER α not only exists overlapping but also different tissue distribution is arranged with ER β.Usually organize and both expressed ER α and also express ER β, but receptor is confined in different types of cell.
In a word, although it is still unknown that estrogenic component of the present invention is brought into play the mechanism of its beneficial effect, but obvious described estrogenic component is different as 17 beta estradiols and ethinylestradiol with estrogen substance, and it demonstrates high relatively affinity to ER α receptor with respect to the ER beta receptor.Can understand also that from the above this species specificity may be to cause estrogenic component of the present invention to female and malely have treatment or prevention estrogen inhibition type tumor and render a service and do not have a reason that increases the shortcoming of suffering from the danger of estrogen stimulating type tumor.
The specific embodiment
Therefore, the present invention relates to the method for estrogen inhibition type tumor in a kind of treatment or the prevention mammal, described method comprises the estrogenic component to described mammal drug treatment effective dose, and wherein this estrogenic component is selected from following group:
The material of following general formula representative
Its Chinese style R
1, R
2, R
3, R
4Be hydrogen atom, hydroxyl or the alkoxyl that contains 1-5 carbon atom independently;
When being applied to the inventive method, can discharge the precursor of aforementioned formula material; And the mixture of one or more aforementioned substances and/or precursor.
Term used herein " tumor " is meant wherein uncontrolled cellular proliferation and is the new growth of progressive tissue.The term tumor had both contained the optimum malignant tumor that also contains.
Term " estrogen inhibition type tumor " is meant and a kind ofly can suppresses its formation and growing tumors by administration estrogen, and is not limited to the tumor that its formation and growth are directly influenced by estrogen.For example, estrogen inhibition type tumor also contains its formation and growth is subjected to the tumor of androgen stimulation and can suppresses its formation and growing tumors by generate effective amount administration estrogen with inhibition endogenous androgen.This example that is considered to the androgen stimulating type tumor of estrogen inhibition type tumor comprises tumor of prostate and prostatic hyperplasia.
Term " estrogen stimulating type tumor " is meant the tumor that a kind of its formation and growth are subjected to (endogenous or exogenous) estrogen except that estrogen compound of the present invention especially to be selected from 17 beta estradiols, to stimulate in conjunction with the estrogen of premarin, ethinylestradiol and precursor thereof and metabolite.
Term " cancer " refers to that process worsens the cell that makes it host's body is produced pathological changes.
Usually the biogenic of using in estrogen substance of the present invention and the pharmaceutical preparation and the difference of synthetic estrogen are, contain 3 rather than 0-2 hydroxyl substituent on the five-membered ring of steroid backbone.In a particularly preferred specific embodiments, R at least
1, R
2, R
3And R
4One of be hydroxyl, this means that this estrogen substance contains 4 hydroxyls at least.Preferably, the estrogenic component that is used as active component in the present composition is that so-called biogenic estrogen is precursor or its mixture of naturally occurring estrogen, biogenic estrogen in the human body.Be present in fetus and the female gonosome because biogenic estrogen is natural, expection side effect can not occur, especially is higher than naturally when having concentration when the serum levels of exogenous this estrogen production of administration is not obvious, more side effect can not occur.
In preferred specific embodiments of the present invention, this estrogen substance contains 4 hydroxyls.In another preferred specific embodiments, R
1, R
2, R
3, R
4In no more than 3 be hydrogen atom.Same, in the aforementioned structural formula, R
1Preferably represent hydrogen atom.In the described structural formula, R
1, R
2, R
3And R
4In preferably at least 2, more preferably represent hydrogen atom at least 3.
Because having the carbon atom of hydroxyl substituent is the chirality activity, the estrogen substance of this structural formula is contained various enantiomer.In a preferred specific embodiments, estrogen substance of the present invention is that 15 Alpha-hydroxies replace.In another preferred specific embodiments, this material is that 16 Alpha-hydroxies replace.In another preferred specific embodiments, this material is that 17 beta-hydroxies replace.This estrogen substance most preferably is 15 α, 16 α, and 17 β-trihydroxy replaces.Other chiral carbon atoies on the estrogenic component steroid backbone of the present invention be preferably with 17 beta estradiols and other biogenic estrogen in corresponding carbon atom have identical configuration.
In preferred specific embodiments of the present invention, R
3Representation hydroxy or alkoxyl.In another preferred specific embodiments, R
1, R
2And R
4Represent hydrogen atom, at this moment this material is 1,3,5 (10)-estratriene-3,15,16, the 17-tetrol.Back one material preferred isomers is 1,3,5 (10)-estratriene-3,15 α, 16 α, 17 β-tetrol (E4).
The application of the precursor of the estrogen substance that constitutes active component is in the method also contained in the present invention.These precursors can discharge aforementioned estrogen substance when being applied to the inventive method, as the product as metabolic conversion.These precursors preferably are selected from the following derivant of estrogen substance of the present invention, and wherein the hydrogen atom of at least one hydroxyl is by the acyl group of the alkylene dicarboxylate of 1-25 carbon atom, sulfonic acid or sulfamic acid; Tetrahydrofuran base; THP trtrahydropyranyl; Or each residue comprises the straight or branched glucosides residue replacement of 1-20 glycoside units.The representative instance that is fit to precursor used according to the invention is by the hydroxyl that makes this estrogen substance and contains wherein M
+Represent one or more carboxyl (M of hydrogen or (alkali) metal cation
+-OOC) ester that substance reaction obtains.Therefore, in a particularly preferred specific embodiments, this precursor is the derivant of estrogen substance, and the hydrogen atom quilt-CO-R of at least one hydroxyl replaces in the wherein said structural formula, and wherein R is the alkyl that contains 1-25 carbon atom.Preferably, R is hydrogen or alkyl, thiazolinyl or the aryl that comprises 1-20 carbon atom.
Method of the present invention is applicable to treating mammal such as domestic animal, house pet and particularly people.Although be used for when female the most effectively, this method both can be used for treating female and also can be used for treating male.Before this method can advantageously be applied to menopause, climacteric and postclimacteric female.
This method is effective especially when continuing medication a period of time.Usually, this method is included in interior uninterrupted this estrogenic component of administration of time of at least five days.This uninterrupted administration is preferably at least and continues 30 days, more preferably at least nine ten days.
The inventive method is applicable to the intestinal or the parenteral administration of this estrogenic component.Transdermal, intravenous, intranasal, intravaginal, pulmonary, oral cavity, subcutaneous, intramuscular and intrauterine administration contained in term used herein " parenteral administration ".Term " intestinal canal administration " comprises oral and rectally.
Preferably, this administering mode is selected from oral, transdermal, intravenous, intranasal, intravaginal, pulmonary, rectum, oral cavity, subcutaneous, intramuscular or intrauterine administration.More preferably, this administering mode is selected from oral, transdermal, intravenous, subcutaneous, intranasal, pulmonary and vagina administration.In a particularly preferred specific embodiments, that the inventive method adopts is oral, transdermal, intranasal or subcutaneous administration.More preferably, the inventive method adopts oral or transdermal administration.
Oral, intravenous, subcutaneous, intramuscular, intranasal, rectum, oral cavity and pulmonary administration are suitable for administration every day (at least) once ideally.Transdermal and intravaginal administration are advantageously to use to mensal frequency once a day.The intrauterine administration is advantageously to use to mensal frequency once in a week.Subcutaneous and intramuscular administration also applicable to the form of injectable depot formulation with 1 thoughtful 6 months interval administration, be preferably with 4 thoughtful 3 months interval administrations.
For facility, the inventive method preferably adopts 1 day, 1 week or 1 month dosing interval.Preferred especially oral once a day, subcutaneous, intravenous or intranasal administration, the therapy of weekly transdermal administration or an intravaginal in every month or subcutaneous administration of adopting.
No matter administering mode is how, this estrogenic component preferably with can effectively reach 1ng/ liter at least, more preferably at least the 10ng/ liter, most preferably be the effective dose administration of the serum-concentration that 100ng/ at least rises.Usually, the serum-concentration that causes of this estrogenic component is no more than 100 μ g/ liters, is preferably and is no more than 50 μ g/ liters, more preferably is no more than 25 μ g/ liters.
According to the inventive method, this estrogenic component usually with every day per kilogram of body weight be less than the dosed administration that 1mg preferred every day of per kilogram of body weight is less than 0.4mg.For making this estrogenic component of administration produce significant effect, suggestion is with the dosed administration of per kilogram of body weight at least 1 μ g every day.Preferably, this dosage is per kilogram of body weight at least 5 μ g every day.
The oral administration of this active component be preferably with every day per kilogram of body weight be less than the dosed administration of 400 μ g, be preferably the every day per kilogram of body weight and be less than 200 μ g.For making this active component of administration produce significant effect, suggestion is with the amount oral administration of per kilogram of body weight at least 2 μ g every day.Preferably, this oral administration amount is per kilogram of body weight at least 5 μ g every day.In the inventive method, when particularly being applied to the mankind, usually with every day at least 0.05mg, be preferably the every day of the mean dose administration estrogenic component of 0.1mg at least.Maximal dose remains on below 40mg every day usually, is preferably below 20mg every day.
Therapeutic Method of the present invention comprises the estrogenic component to the mammal effective dosage of this treatment of needs.Reach effective required amount and between individuality and individuality, there are differences, and by factors such as the effectiveness decision as individual sex, body weight, route of administration and used specific estrogenic component.
In the methods of the invention, when particularly being applied to the mankind, usually with every day 0.01 to 20mg, be preferably the mean dose oral administration estrogenic component of every day 0.05 to 10mg.Similarly, parenteral route dosage be preferably every day at least 0.05mg, be preferably 0.1mg at least.The average maximum of parenteral route dosage remains on below 40mg every day usually, is preferably below 20mg every day.
In a particularly preferred specific embodiments of the present invention, this method adopts this active estrogen composition oral administration.Term oral administration used herein is also contained the administration of per os tube feed.The present inventor finds that although its effectiveness is very low, E4 can be advantageously with oral administration with relevant estrogen substance.Though the present inventor is not wishing to be bound by theory, but still think that the effect of oral administration E4 class material is that specific drugs kinetics (ADME) and pharmacodynamic properties by these materials causes jointly.
The present inventor finds that the oral administration biaavailability of E4 class material is unexpectedly high, and the interior half-life of its body is longer than normally used biogenic estrogen.Therefore, relatively low although the estrogen of E4 and E4 class material is renderd a service, because it is similar to the dosage that is used for as 17 beta estradiols to reach the oral dose of required effect, so they can be effectively with the oral way administration.
Another significant advantage of oral administration E4 and E4 class material is these materials, and not to be considered to the liver effect by metabolism substantially in so-called " first pass effect " very little owing to it.The first pass effect of oral drugs is meant that medicine is transported to the process that blood circulation process Chinese medicine is degraded by liver from initial picked-up.After heavily absorbing from enteric cavity, Orally administered active component enters body through liver.This fact is to the estrogenic particular importance, because liver is estrogenic target organ, orally ingestible estrogen causes intensive estrogen action at liver.When oral using, the treatment dose,equivalent of normally used biogenic estrogen can cause tangible liver parameter reaction, as the increase of SHBG, CBG and proangiotensin.When using premarin (so-called premarin), also can be observed estrogenic these liver effects.
Method of the present invention comprises (preventative) treatment of colorectum tumor and tumor of prostate applicable to various estrogen inhibition type tumors.When treatment or prevention carcinoma of prostate, estrogenic component of the present invention is suitable for can effectively suppress the amount administration that the androgen endogenous generates.Method of the present invention can the most advantageously be applied to prevention or treatment colorectum tumor, is more preferably used in prevention or treatment colon tumor.
In a particularly preferred specific embodiments of the present invention, this method is used for the treatment of to be suffered from or once suffered from optimum or the malignant tumor mammal of colorectum tumor particularly.Developing in the tumor mammal of (comprising adenoma), though these tumors excision or remove with method for distinguishing, but the danger of suffering from estrogen stimulating type cancer still is considered to especially high.Therefore, owing to use common estrin treatment will bring serious harm, the advantage of the inventive method in these mammals of treatment is particularly remarkable.The inventive method can the most advantageously be applied to the mammal that therapeutic treatment suffers from estrogen inhibition type tumor.
In a preferred specific embodiments, the inventive method comprises that the progestogen of administering drug combinations effective dose are to suppress the generation of endogenous estrogen.The administering drug combinations progestogen can provide other advantage, and promptly known progestogen can suppress estrogen to endometrial proliferative effect.Although different with common estrogen, estrogenic component of the present invention does not have significant proliferative effect to endometrium, and the administering drug combinations progestogen are still desirable to get rid of any potential danger.
The example of progestogen that can be used according to the invention comprises: progesterone; levonorgestrel; norgestimate; norethindrone; dydrogesterone; drospirenone; 3-beta-hydroxy desogestrel; 3-ketone-desogestrel (=etonogestrel); 17-deacetylate norgestimate; the 19-norprogesterone; the acetoxyl group pregnenolone; the female alcohol of pi-allyl; anagestone; chlormadinone; cyproterone; demegestone; desogestrel; dienogest; dihydroprogesterone (dihydrogesterone); dimethisterone; ethisterone; ethynodiol diacetate; flurogestone acetate; gastrinon; the gestodene; gestrinone; the methylol progesterone; hydroxyprogesterone; lynestrenol (=lynoestrenol); medrogestone; medroxyprogesterone; megestrol; melengestrol; nomegestrol; norethindrone (=norethisterone); Norethynodrel; norgestrel (comprising d-norgestrel and dl-norgestrel); norgestrienone; normethisterone; progesterone; quingestanol; (17 α)-17-hydroxyl-11-methylene-19-nor-pregnant-4; 15-diene-20-alkynes-3-ketone; tibolone; trimegestone; algestone acetonide; nestorone; promegestone; the 17-Gestageno Gador; 19-is nor--the 17-hydroxyprogesterone; 17 α-pregnine; 17 α-acetenyl-19-nortestosterone; d-17 β-acetoxyl group-13 β-ethyl-17 α-acetenyl-steroid-4-alkene-3-ketoxime, and the precursor that can discharge these chemical compounds of these progestogen when being applied to the inventive method in vivo.Preferably, the progestogen that are applied to the inventive method are selected from the precursor of progesterone, desogestrel, etonogestrel, gestodene, dienogest, levonorgestrel, norgestimate, norethindrone, drospirenone, trimegestone, dydrogesterone, these progestogen and their mixture.
In principle, as US 5,340,585 and US 5,340,584 in the GnRH compositions put down in writing also can be applicable in the inventive method.Yet method of the present invention is not preferably used these GnRH compositionss.
The present invention relates to pharmaceutical composition on the other hand, and it comprises:
A. at least 0.05mg as defined estrogenic component before this;
B. at least 0.01mg be selected from 5 inhibitor, androgen antagonist, Cytochrome P450
17 αThe antineoplastic component of inhibitor, α 1 adrenoceptor blocker and microtubule inhibitor; And
C. the acceptable excipient of materia medica.
Unite and use estrogenic component of the present invention and the treatment of aforementioned antineoplastic component and prevention estrogen inhibition type tumor more more effective than using this estrogenic component or this antineoplastic component separately.When this antineoplastic component can as pass through to suppress androgenic biosynthesis (5 inhibitor and Cytochrome P450
17 αInhibitor) when suppressing in the body androgenic activity in conjunction with androgen receptor (androgen antagonist), this therapeutic alliance is effective especially or by competitive.
Survey article (" Inhibitors of enzymes of androgenbiosynthesis:cytochrome P450 according to Jarman etc.
17 αAnd 5 α-steroid reductase ", Nat Prod Rep.1998 Oct; 15 (5): 495-512) set forth 5 inhibitor and Cytochrome P450
17 αInhibitor can be used as the potential weapon of antagonism carcinoma of prostate and benign prostatic hyperplasia.Authors observe that about 80% patients with prostate cancer suffers from androgen-dependent disorders and excision has reaction to hormone.Because Cytochrome P450
17 αInhibitor can stop the biosynthesis for the androgen dehydroepiandrosterone of testosterone and 5 α-dihydrotestosterone precursor, and the 5 inhibitor can stop the biosynthesis that is considered to deleterious especially androgen 5 α-dihydrotestosterone, so these enzyme inhibitors can advantageously be applied to treat carcinoma of prostate.
The example that is fit to the 5 inhibitor of application according to the present invention comprises finasteride, dutasteride (GI-198745), epristeride, turosteride, sterin fat extract (lipidosterolextract).Abiraterone is the Cytochrome P450 that can advantageously use according to the present invention
17 αThe example of inhibitor.The androgen antagonist that can be used in the inventive method is selected from cyproterone acetate, acetic acid osaterone, chlormadinone acetate, flutamide, nilutamide and bicalutamide.
Treatment of prostate cancer failure is usually owing to non-androgen-dependent development in late period with to the drug resistance of chemotherapeutics.Recently, it is reported that α 1 adrenoceptor blocker such as terazosin can suppress the growth of prostate gland cancer cell.(" The alphal-adrenoceptor antagonist terazosininduces prostate cancer cell death a p53 and Rb independent pathway ", OncolRep, 2003 Sep-Oct such as Xu; 10 (5): 1555-60) the report terazosin can not only suppress the growth of prostate gland cancer cell and can suppress one-tenth colony ability for the main target of chemotherapy.The example of α 1 adrenoceptor antagonists that can use according to the present invention comprises terazosin, ABT-980, ABT-627, doxazosin, prazosin, alfuzosin, indoramine and tamsulosin.
The microtubule inhibitor has been proposed the chemotherapeutics as prostate cancer therapy.Picus and Schultz (" Docetaxel (Taxotere) as monotherapy in the treatment of hormone-refractory prostate cancer:preliminary results ", Semin Oncol.1999 Oct; 26 (5 Suppl 17): 14-8) reported have the substantially persistent activity of docetaxel as single medicine treatment hormone intractable carcinoma of prostate.The suitable example of microtubule inhibitor comprises taxotere and paclitaxel.
A specific specific embodiments of the present invention relates to the drug delivery system that comprises aforementioned pharmaceutical compositions, and described drug delivery system is selected from oral dosage units, injectable liquids, suppository, gel and emulsifiable paste.
Another specific specific embodiments relates to a kind of medicine box, and this medicine box comprises one or more dosage units of the defined before this estrogenic component of 0.05mg and the acceptable excipient of materia medica at least that contain; One or morely contain at least that 0.01mg is selected from 5 inhibitor, androgen antagonist, Cytochrome P450
17 αInhibitor, α 1 adrenoceptor blocker and the antineoplastic component of microtubule inhibitor and the dosage unit of pharmaceutically-acceptable excipients.In a particularly preferred specific embodiments, aforementioned dosage unit is an oral dosage units.
By the following examples, the present invention is further illustrated.
Embodiment
Embodiment 1
Measure E4 in the ovariectomized female rats 1 by test, the effect of the inductive colon cancer of 2-dimethylhydrazine (DMH).
The development of the inductive cancer of DMH is selected as the model of " estrogen inhibition type tumor ", because the situation of it and human colon's cancer is very approaching:
1) histology's test that the normal position of tumor (orthotopically) growth also can be identical is divided into adenocarcinoma,
2) approach identical (tumor is grown and the development from the adenoma to the cancer relatively slowly) of transitivity generation, and
3) as reporting (Greene etc., 1987, J.Surgical Research, 43,476-487 before; Madara etc., 1983, Am.J.Pathology, 110,230-235; Smirnoff etc., 1999, Oncology Research, 11,255-264), 17 beta estradiols can provide protection in this model.
Induce the last week of colon cancer, castrate the female Sprague-Dawley rat (Harlan, The Netherlands) of 50 sexually matured weight between 150 to 200 grams by extracing operation on ovary.Experimental session, rat being placed bright/dark cycle period is 12 hours the plastics cage of separating, free pickuping food (Purina chow) and water.
Animal is divided into five groups at random, and every group comprises 10 rats, experimental session, and from the beginning in three days of oophorectomize postoperative and to the postmortem end, these rats are accepted placebo or E4 treatment as follows:
● the acceptance of the 1st treated animal contains the placebo oral medication of 3.0ml/kg/ days carrier (the HP-aqueous solution of 20% mass/volume);
● the single daily dose of the oral acceptance of the 2nd treated animal is the E4 of 0.1mg/kg;
● the single daily dose of the oral acceptance of the 3rd treated animal is the E4 of 0.3mg/kg;
● the single daily dose of the oral acceptance of the 4th treated animal is the E4 of 1.0mg/kg;
● the single daily dose of the oral acceptance of the 5th treated animal is the E4 of 3.0mg/kg.
From one week of oophorectomize postoperative, the animal of all groups is with the interval in a week continuous 5 all subcutaneous administration DMH injections (every 100g body weight 14.7mg DMH dihydrochloride), and this injection uses the solution of freshly prepared DMH dihydrochloride in Hank ' s balanced salt solution.
The 15 weeks back execution rat of the DMH of administration for the first time.During postmortem, sever all animals and open colon, the visible tumor of any cardinal principle of scrutiny before further microscopic analysis.Determining virulent standard is based on, the inspection and the tumor of tumor histology's feature are invaded submucosal observation evidence.Effectiveness analysis only comprises malignant tumor.
In the rat of only using vehicle treatment, constant administration DMH causes producing pernicious colon tumor.In animal groups in advance with the dosage range administration E4 that increases progressively, the quantity of malignant tumor with every day oral E4 dosage reduce from 0.1 to 3.0mg/kg/ day increase.
Embodiment 2
The competitive steroidal of adopt determining in conjunction with test determination E4 (E4) with respect to 17 α-ethinyl estradiol (EE) and 17 beta estradiols (E2) for and the RA of human α and beta type estrogen receptor (ER).
The method that is adopted is according to scientific and technical literature reorganization, and by write ups such as Osboum (1993, Biochemistry, 32,6229-6236).From the Sf9-of transfection cell purification recombinant human ER α and ER β albumen.In vitro tests comprise use ER α or ER β albumen and with the 0.5nM fixed concentration [
3H] E2 is as tagged ligand.Recombinant human ER α and ER β albumen are dissolved in the binding buffer liquid (10mM Tris-HCl, PH7.5,10% glycerol, 1mM DTT, 1mg/ml BSA), with double aliquot and ultimate density be afterwards 0.5nM [
3H] E2 and vehicle Control (0.4%DMSO) or equivalent comprise unmarked steroidal part that concentration increases progressively as the carrier of competitor incubation together.In 25 ℃ of incubations after 2 hours, remove unconjugated part and measure be bonded to ER α or ER β proteic [
3H] amount of E2.Be used in be bonded to ER α under every kind of competitor concentration or ER β proteic [
3H] meansigma methods of E2 amount draws and suppresses curve.Determine the IC50 value by non-linear, least squares regression analysis subsequently.Utilize Cheng and Prusoff equation (Cheng etc., 1973, Biochem.Pharmacol., 22,3099-3108), the concentration of applied radioligand and suppress constant (Ki) in the IC50 value by measured testing compound, the test through determining the Kd history value that ER α and ER β are respectively the radioligand of 0.2nM and 0.13nM calculated.The biochemical test result of E4 in three are independently tested is expressed as the bonded inhibition percent of specificity (table 1).For relatively E4, EE and E2 list the Ki value of experimental observation to human ER α and the proteic binding affinity of ER β in table 2.Compare with E2 with EE, E4 the proteic associative list of ER α is revealed uniqueness with very strong advantage (400%) in conjunction with feature (table 2).Comparatively speaking, EE and E2 steroidal part are to the proteic Ki value of ER β more remarkable (table 2).
Table 1: use E4 as unmarked steroidal part, 0.5nM[
3H] specificity of the competitor that serves as a mark is in conjunction with ER α and the proteic inhibition percent of ER β.Be depicted as the result of three independent trialss.
The bonded inhibition percentage ratio of specificity
E4 is final
ER α steroidal is in conjunction with testing ER β steroidal in conjunction with test
Concentration
Test 1 test 2 tests 3 tests 1 test 2 tests 3
1μM 98 nd nd 87 90 95
0.3μM 92 94 101 74 74 77
0.1μM 83 85 86 56 54 50
0.03μM 64 66 63 19 25 30
10nM 43 32 28 nd nd nd
3nM 26 17 11 nd nd nd
Nd: do not detect
Table 2: the E4 of test determination (E4), 17 α-ethinylestradiol (EE) and 17 beta estradiols (E2) are to human ER α and the proteic inhibition constant K of ER β i.Be shown as protein bound relative potence equally with ER α.
Relatively
KiERα KiERβ
The steroidal part
ERα/ERβ
(nM) (nM)
Advantage (%)
EE 0.23 0.025 11
E2 0.21 0.015 7
E4 4.9 19 400
Embodiment 3
For further estimating the antitumor usefulness of estrogen substance of the present invention,, in the inductive rat tumor model of 12-dimethylbenzanthracene (DMBA) E4 is tested with 7.By Huggins equal 1961 (Nature, 19,204-207) initial this model of setting up is widely used, and is received model to people's series antineoplastic medicament tool predictive value.An example of the inductive growth of tumor representative of DMBA " estrogen stimulating type cancer " in the rat, and depend on the estradiol of endogenous generation or estrogen and prolactin antagonist (Sylvester etc., 1982, the Cancer Research of exogenous administration, 42,4943-4947).It is found that ovariectomy in the DMBA model (Hollingsworth etc., 1998, Breast Cancer Research and Treatment, 47,63-70), androgen (Dauvois etc., 1989, Breast Cancer Treatment, 14,299-306), tamoxifen (Hollingsworth etc., 1998, Breast Cancer Research and Treatment, 47,63-70), progestogen (Kelly etc., 1979, Eur.J.Cancer, 15,1243-1251; Russo etc., 1987, Lab.Invest.57,112-137) and the GnRH analog (Hollingsworth etc., 1998, Breast Cancer Research and Treatment, 47,63-70) be effective antitumour treatment.
That 84 female Sprague-Dawley rats (Harlan, The Netherlands) place is bright/and dark cycle period is that 12 hours environment is raised in groups, freely takes in Soya Free Diet (SDSEngland) and water.Animal is weighed weekly.Inducing breast carcinoma the last week, by extracing operation on ovary castrating 12 animals (43 day age).When 50 day age, take place with induced tumor to the 16mg DMBA of the single oral dose of all animals administers.Subsequently animal is divided into seven groups (n=12), accepts following placebo or treatment:
● the acceptance of the 1st treated animal contains the placebo oral medication of 3.0ml/kg/ days carrier (the HP-aqueous solution of 20% mass/volume);
● the animals received of the 2nd group of operation castrating contains the placebo treatment of 3.0ml/kg/ days carrier;
● the single daily dose that the 3rd treated animal is accepted oral administration is the estrogen antagonist tamoxifen of 3mg/kg;
● the oral ethinylestradiol that single daily dose is 0.025mg/kg (EE) of accepting of the 4th treated animal;
● the oral ethinylestradiol that single daily dose is 0.125mg/kg (EE) of accepting of the 5th treated animal;
● the oral E4 that single daily dose is 0.5mg/kg (E4) of accepting of the 6th treated animal;
● the oral E4 that single daily dose is 2.5mg/kg (E4) of accepting of the 7th treated animal.
The dosage of EE and E4 is based on previous data, and the E4 of 0.025mg/kg/ days EE of this data show and 0.5mg/kg/ days heavily absorbs, prevents equivalence in the cornified exciting model of hot flush and vagina in prevention of osteoporosis.Similarly, the dosage of 0.125mg/kg/ days EE and 2.5mg/kg/ days E4 heavily absorbs, prevents the body inner estrogen usefulness equivalence in hot flush and the vagina keratinization in prevention of osteoporosis.
During the treatment in 8 weeks by a definite date, measure the appearance of noticeable tumor and the quantity of tumor weekly.In the 8th week, carry out last measurement during postmortem.The quantity of tumor as shown in Figure 1 during postmortem.Tumor do not occur as (the 2nd group) in the cut animal of ovary and clearly illustrate, the inductive breast tumor of DMBA occur as estrogen-dependent.As expected, tamoxifen also demonstrates the antitumor characteristic by the generation that suppresses breast tumor in this model.Beat allly be, compare that the E4 under 2.5mg/kg/ days equivalent exciting dosage can significantly suppress breast tumor to be taken place with the effect that the EE of 0.125mg/kg/ days dosage is shown.In addition, this specific E4 dosage is the same with tamoxifen effective aspect the inductive tumor generation of prevention DMBA.
Fig. 1: the tumor quantity (n=12) of each treatment group
The 1st group with 3.0ml/kg/ days carrier oral medication;
The 2nd group of animal of accepting the operation castrating of placebo treatment with 3.0ml/kg/ days carrier;
The 3rd group oral tamoxifen 3mg/kg/ days;
The 4th group of oral ethinylestradiol (EE) 0.025mg/kg/ days;
The 5th group oral EE 0.125mg/kg/ days;
The 6th group of oral E4 (E4) 0.5mg/kg/ days;
The 7th group oral E42.5mg/kg/ days.
Claims (9)
1, a kind of estrogenic component that is selected from following group is used for the treatment of or prevents application in the pharmaceutical composition in the method for mammal estrogen inhibition type tumor in preparation:
1,3,5 (10)-estratriene-3,15 α, 16 α, 17 β-tetrol;
Can discharge 1,3,5 (10)-estratriene-3 when being applied to method of the present invention, 15 α, 16 α, the precursor of 17 β-tetrol, wherein said precursor is 1,3,5 (10)-estratriene-3,15 α, 16 α, the derivant of 17 β-tetrol, wherein the hydrogen atom quilt-CO-R of at least one hydroxyl replaces, and wherein R is the alkyl that contains 1-25 carbon atom; And
1,3,5 (10)-estratriene-3,15 α, 16 α, the mixture of 17 β-tetrol and described precursor;
Described method comprises this estrogenic component to described mammal drug treatment effective dose.
2, that application as claimed in claim 1, wherein said medicine are configured to is oral, transdermal, intravenous or subcutaneous administration dosage form.
3, application as claimed in claim 2, wherein said medicine is configured to oral administered dosage form.
4, application as claimed in claim 1, wherein said estrogen inhibition type tumor is selected from colorectum tumor or tumor of prostate.
5, application as claimed in claim 1, wherein said mammal suffer from or once suffered from optimum or malignant tumor.
6, application as claimed in claim 5, wherein said mammal suffer from or once suffered from the colorectum tumor.
7, application as claimed in claim 1, wherein said mammal are female.
8, the application described in claim 7, wherein said mammal are human women.
9, application as claimed in claim 1, wherein said method comprises the administering drug combinations progestogen.
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| EP02079414 | 2002-10-23 |
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| EP (1) | EP1556058B1 (en) |
| CN (1) | CN100528167C (en) |
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| Breast and prostate cancer: An analysisofcommonepidemiological,genetic,and biochemicalfeatures..LOPEZ-OTIN C,et al.ENDOCRINE REVIEW,Vol.19 No.4. 1998 * |
| SIMILARITIES OF PROSTATE AND BREASTCANCER:EVOLUTION,DIET,AND ESTROGENS..COFFEY D S.UROLOGY,Vol.57 No.4A. 2001 * |
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| ES2298570T3 (en) | 2008-05-16 |
| US9561238B2 (en) | 2017-02-07 |
| ATE380552T1 (en) | 2007-12-15 |
| DE60318092D1 (en) | 2008-01-24 |
| US8987240B2 (en) | 2015-03-24 |
| AU2003274823A1 (en) | 2004-05-13 |
| US20060247221A1 (en) | 2006-11-02 |
| CA2503549A1 (en) | 2004-05-06 |
| US20150150887A1 (en) | 2015-06-04 |
| CY1107862T1 (en) | 2013-06-19 |
| WO2004037269A1 (en) | 2004-05-06 |
| SI1556058T1 (en) | 2008-02-29 |
| DE60318092T2 (en) | 2008-11-27 |
| CA2503549C (en) | 2012-07-10 |
| EP1556058B1 (en) | 2007-12-12 |
| PT1556058E (en) | 2008-03-20 |
| EP1556058A1 (en) | 2005-07-27 |
| CN1732007A (en) | 2006-02-08 |
| DK1556058T3 (en) | 2008-03-03 |
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